I certify that the information set forth in the registration form is true and correct, and that the named participant was born on the dated indicated and has my permission to participate in the "How to Build a Goalkeeper" Soccer Camp ("Camp") sponsored by the White Clay Soccer Club, ("WCSC") and Brandywine Youth Club (BYC). I also understand that the primary health insurance coverage for the participant is my individual or family plan. I hereby release, waive, discharge and covenant not to sue WCSC/AGRA, BYC, its' agents,representatives, and any instructor at the Camp from all liability to the participant, the undersigned and their personal representatives,assigns,heirs, and next of kin for any or all losses, damages, and any claims or demands for the same, on account of injury, to the person or the property of the participant while participating in the Camp. By my signature below, I hereby ackowledge reading and understanding the nature of my waiver and release.
